Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.08.025
Brazilian Journal of Anesthesiology
Case Report

Intracranial rebleeding post spinal anesthesia in pregnant patient with undiagnosed chronic subdural hematoma – case report

Laura Bisinotto Martins, Flora Margarida Barra Bisinotto, Roberto Alexandre Dezena, Rafael Meirelles

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Abstract

Intracranial hematoma after spinal anesthesia is a rare complication. It generally presents with posture-dependent headache that becomes persistent. We describe the case of patient submitted to spinal anesthesia for cesarean section who presented a non-posture-dependent headache, resistant to clinical treatment, that progressively worsened and with symptoms of intracranial hypertension. The patient had a history of head trauma without symptoms. The CT-scan revealed a chronic bilateral parietal hematoma with a recent bleeding component, treated surgically. We concluded that spinal puncture led to chronic hematoma to rebleed. We have reported the case to draw attention to the importance of investigating atypical headache after spinal anesthesia.

Keywords

Anesthesia techniques;  Spinal anesthesia complications;  Postdural puncture headache;  Subdural hematoma

References

1 FMB Bisinotto, RA Dezena, DC Fabri, et al. Hematoma subdural intracraniano: uma rara complicação após raquianestesia: relato de caso Rev Bras Anestesiol, 62 (2012), pp. 88-95

2 JA Amorim, DSCA Remígio, O Damázio Filho, et al. Hematoma subdural intracraniano pós-anestesia subaracnoidea: Relato de dois casos e revisão de 33 casos da literatura Rev Bras Anestesiol, 60 (2010), pp. 620-629

3 DA. Marcus Expert Rev Neurotherapeutics, 8 (2008), pp. 385-395

4 IB Park, SY Moon, YY Kim, et al. Acute-on-chronic subdural hematoma by spinal anesthesia in a patient with undiagnosed chronic subdural hematoma. A case report Korean J Anesthesiol, 61 (2011), pp. 75-78

5 W Yang, J. Huang Chronic subdural hematoma: Epidemiology and natural history Neurosurg Clin N Am, 28 (2017), pp. 205-210

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Braz J Anesthesiol

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